Update on Desensitization

Purpose of reviewRapid drug desensitization (RDD) is a high-risk protocol that allows patients with hypersensitivity reactions to remain on first-line therapy for their underlying conditions through titration of dose increments and infusion rates. The aim of this paper is to review the most recent desensitization protocols available for drugs that are commonly used in clinical practice settings and to provide algorithms for their appropriate usage.Recent findingsRDD protocols involve identification of phenotypes and endotypes during the initial reaction, risk stratification, skin testing, and specific biomarkers. Patients' protocols are personalized and can increase life expectancy and quality of life.SummaryThe benefits of RDD largely outweigh the risks. All patients with hypersensitivity reactions should be evaluated for desensitization, to avoid alternatives treatments that may be less effective or intolerant patients presenting with SCARS (DRESS/SJS/TEN) are not candidates for desensitization since the mechanism of the reactions are poorly understood.